Live Birth Following Uterine Transplantation From a Nulliparous Deceased Donor
Language English Country United States Media print
Document type Case Reports, Research Support, Non-U.S. Gov't, Journal Article
PubMed
32541565
DOI
10.1097/tp.0000000000003346
PII: 00007890-202105000-00023
Knihovny.cz E-resources
- MeSH
- Reproductive Techniques, Assisted MeSH
- Tissue Donors * MeSH
- Time-to-Pregnancy MeSH
- Adult MeSH
- Mullerian Ducts abnormalities MeSH
- Fertility * MeSH
- Humans MeSH
- Young Adult MeSH
- Live Birth MeSH
- Parity * MeSH
- Postoperative Complications etiology therapy MeSH
- 46, XX Disorders of Sex Development complications MeSH
- Stents MeSH
- Pregnancy MeSH
- Uterus transplantation MeSH
- Congenital Abnormalities MeSH
- Donor Selection MeSH
- Treatment Outcome MeSH
- Infertility, Female diagnosis etiology physiopathology surgery MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Nulliparous uterine grafts have never been used in uterus transplantation (UTx), possibly due to presumed infertility. Our objective was to verify the feasibility of nulliparous uterine graft transplantation. METHODS: The Czech Uterus Transplant Trial (registered under ClinicalTrials.gov, identifier NCT03277430) is a 2-arm trial comparing the efficacy of deceased donor (DD) versus live-donor uterus transplant (10 patients in both arms). A 25-year-old patient suffering from inborn absolute uterine factor infertility underwent a DD uterus transplant. The donor was a 20-year-old nulliparous brain-dead donor. RESULTS: The transplant procedure was uneventful. The posttransplant period was complicated by (1) recurrent episodes of acute cellular rejection, (2) neutropenia necessitating the administration of granulocyte colony-stimulating factor, (3) vaginal anastomotic stenosis treated with the insertion of a self-expanding stent, (4) the concurrence of Clostridium difficile colitis and acute appendicitis, and (5) temporary renal function impairment of a combined cause. Two years after the UTx, after the fourth embryo transfer, the patient became pregnant. Apart from gestational diabetes mellitus, the pregnancy was uneventful. Due to preterm contractions, delivery was achieved via caesarean section at gestational age 34 + 6 years. The postoperative course was uneventful for both the mother and the newborn. CONCLUSIONS: Herein, we report the first live birth after a DD UTx in Europe. This report provides a proof of concept that nulliparous uteri may present a suitable source of uterine grafts for UTx. Stenting may serve as a feasible treatment method for vaginal anastomotic stenosis.
1st Faculty of Medicine Charles University Prague Czech Republic
2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Anatomy 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Transplantation Surgery Sahlgrenska University Hospital Gothenburg Sweden
Transplant Surgery Department Institute for Clinical and Experimental Medicine Prague Czech Republic
See more in PubMed
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ClinicalTrials.gov
NCT03277430
